Software development for managing nutrition intake for Type II Diabetes Mellitus

In this paper, we present the development and use of a nutrition assessment software namely Nutritracs for Type II Diabetes Mellitus (T2DM). We conducted a case study in India to understand how diet counselling impacts upon Type II Diabetes Mellitus (T2DM) management. We also highlight practical challenges in conducting such studies in developing countries and how we have addressed them, and the promising outcome in T2DM management - reduced the dependency on insulin as a management tool

Targeted, structured text messaging to improve dietary and lifestyle behaviours for people on maintenance haemodialysis (KIDNEYTEXT): Study protocol for a randomised controlled trial

Introduction Managing nutrition is critical for reducing morbidity and mortality in patients on haemodialysis but adherence to the complex dietary restrictions remains problematic. Innovative interventions to enhance the delivery of nutritional care are needed. The aim of this phase II trial is to evaluate the feasibility and effectiveness of a targeted mobile phone text messaging system to improve dietary and lifestyle behaviours in patients on long-term haemodialysis. Methods and analysis Single-blinded randomised controlled trial with 6 months of follow-up in 130 patients on haemodialysis who will be randomised to either standard care or KIDNEYTEXT. The KIDNEYTEXT intervention group will receive three text messages per week for 6 months. The text messages provide customised dietary information and advice based on renal dietary guidelines and general healthy eating dietary guidelines, and motivation and support to improve behaviours. The primary outcome is feasibility including recruitment rate, drop-out rate, adherence to renal dietary recommendations, participant satisfaction and a process evaluation using semistructured interviews with a subset of purposively sampled participants. Secondary and exploratory outcomes include a range of clinical and behavioural outcomes and a healthcare utilisation cost analysis will be undertaken. Ethics and dissemination The study has been approved by the Western Sydney Local Health District Human Research Ethics Committee-Westmead. Results will be presented at scientific meetings and published in peer-reviewed publications. Trial registration number ACTRN12617001084370; Pre-results

Risk Factors of Diabetes Mellitus in Rural Puducherry

Purpose: Prevalence of type 2 diabetes is increasing in India. Rural area constitutes 80% of India. Hence it is essential to understand the epidemiology for appropriate interventions. Objectives: to identify risk factors of type 2 diabetes mellitus in rural Puducherry. Methodology: Cross sectional study in two villages of Puducherry, India. 1403 subjects above 25 years from 2 villages. Study measured demographic variables, Body Mass Index (BMI), physical activity, family history of Diabetes Mellitus, smoking and alcohol consumption. Fasting blood glucose was measured for study subjects. Further, those with >126 mg/dl were subjected for Oral Glucose Tolerance Test. Univariate and multivariate analysis was done. Receiver Operating characteristic Curve was plotted to find out cut off for Diabetic Risk Score. Findings: The prevalence of type 2 Diabetes Mellitus (DM) was 5.8%. The response rate was (88%). In univariate analysis age, occupation, Socio Economic Status, BMI, physical activity, family history were significant for DM. In multivariate analysis age, BMI, family history of diabetes and occupation were significant for type 2 DM. The ‘diabetes risk score’ generated by the study using age, BMI and family history of DM, had specificity, sensitivity and accuracy of 54%, 77% and 76.2% respectively. The area under curve for scoring system was 0.784 (<0.05). Conclusions: Identified risk factors are useful for early diagnosis by using ‘diabetes risk score’ – thus uncovering the iceberg of disease

Towards effective dietary counseling:a scoping review

Objective The aim of this scoping review was to identify and map available evidence concerning counseling strategies that contribute to effective DC. Methods Following the PRISMA SCR-Scoping Reviews Statement and Checklist, a systematic search in electronic databases was performed in March 2020. Results Synthesis of recurring themes in the 28 included studies revealed seven core counseling strategies that effectively contribute to DC: 1) connecting to motivation, 2) tailoring the modality of DC, 3) providing recurring feedback, 4) using integrated dietetic support tools, 5) showing empathy, 6) including clients’ preferences, wishes, and expectations during decision-making, and 7) dietitians having high self-efficacy. Conclusions Multiple counseling strategies contributing to effective DC have been identified and mapped. The counseling strategies identified seem to interrelate, and their conceived interrelatedness reveals that strategies can both compliment or contrast each other. Therefore, advancing effective DC requires further development towards an integrated approach to DC that includes combinations of strategies that form a unified whole. Practical implications Insights from this scoping review provide a foundation for dietitians to effectively carry out DC and serve as a starting point to further work towards effective DC

Exploring the Effects of Different Types of Diets on Preventing and Managing Diabetes Mellitus Type 2

Diabetes is a major health problem that is becoming an epidemic in major countries of the world. Diabetes can affect people of all ages and of all races. However, there is a higher risk of developing diabetes for certain groups of people. As of today, there is still no cure for diabetes. The treatment plan for patients diagnosed with diabetes is to control the level of blood glucose through different interventions. The progression of diabetes is influenced by food behaviors, and diet control is an important aspect of management of this disease. There are different types of diet recommended that will not affect blood glucose levels. However, these types of diets do not coincide with many people\u27s culture and dietary habits. This paper consists of six studies that explores the effect of different types of diet on maintaining or preventing DM2. Studies are divided into two categories: weight loss targeted diet and disease specific to ethnic groups. Studies from both categories show positive effects on the glycemic index of individuals with Diabetes Mellitus Type 2. The studies in this literature highlights the effects of diets that are fiber-rich diets rich in fiber, but carbohydrate rich diets, on which some cultures rely, are not included. Further research is needed. A research proposal is described at the end of this paper

Hemodialysis Care Staff Perceptions on Barriers to Optimal Health: Results from a Qualitative Study and National Survey

Chronic Kidney Disease (CKD) is currently the ninth leading cause of death in the United States, and despite the favorable outcomes reported in previous studies, mortality rates for CKD have yet to show improvement. The purpose of this study was distinguish between the different strategies used to treat CKD as perceived by renal practitioners. It is hypothesized that the lack of improvement in mortality rates may be attributed to the lack of cardiovascular protection

The Difference in A1C of Children and Adolescents with Type 1 Diabetes Mellitus using Carbohydrate Counting compared to those using a Structured Meal Plan

Carbohydrate counting (CHO) is a nutrition education tool used by patients with type 1 diabetes mellitus (T1DM). The primary objective was to assess glycated hemoglobin (A1C) in participants with T1DM using CHO counting vs. those using a structured meal plan (SMP). The secondary objectives were to determine if BMI-for-age, parental income, parental involvement, and mothers’ educational level were associated with their children’s glycemic control. A cross sectional study was conducted, where participants aged 4-18 years, or their parents completed a survey. Total sample size was 88 participants (77 in the CHO counting group and 11 in the SMP group). There were no differences in demographic variables or A1C between the two groups. Unexpectedly, there was a very high proportion of participants in the CHO counting group; so there were few statistical differences between the groups. The qualitative data emphasized CHO counting as a challenge patients faced, especially when eating out